Texas
2:49 pm
Tue February 28, 2012

Texas Doctor Charged in Largest Medical Fraud Case Ever

Everything’s bigger in Texas – even the indictments.

Today, the U.S. Department of Justice (DOJ) indicted a Texas doctor and his associates on $365 million in fraudulent Medicare and Medicaid billings – the largest single medical fraud case ever alleged by the government.

In Dallas, DOJ officials announced charges against Dr. Jacques Roy and six others associated with his company, Medistat. Remarks from Deputy Attorney General James Cole provide more details:

The indictment alleges that Dr. Roy’s company, Medistat, consisted of just four doctors and approximately fifteen nurses.   Yet, for the five years covered by the indictment, Dr. Roy’s company is alleged to have certified more Medicare beneficiaries for home health services, and had more beneficiaries under its care, than any other medical practice in the United States.

Over the course of those five years, Medistat is alleged to have certified more than 11,000 Medicare beneficiaries for home health services provided by more than 500 home health care agencies, or HHAs.   In turn, these HHAs and Medistat are alleged to have fraudulently billed Medicare for more than $350 million, and Medicaid for more than $24 million.

The DOJ accuses Roy and owners from home health care agencies of stealing federal health funds by fraudulently signing up customers “so that they could bill Medicare for the unnecessary and not provided services.”

A DOJ release states one provider, Charity Eleda, “allegedly visited The Bridge Homeless Shelter in Dallas to recruit homeless beneficiaries staying at the facility, paying recruiters $50 per beneficiary they found at The Bridge and directed to Eleda’s vehicle parked outside the shelter’s gates.”